Fentanyl Addiction During Pregnancy: Choosing Motherhood Transformed Their Futures.
Eight months pregnant and in severe pain, the expectant mother arrived at the hospital emergency room after her infection worsened up her legs. Without a job or home, estranged from her family, she resided in a small structure she had assembled in a acquaintance's garden. She was also hooked on fentanyl.
As medical staff managed her infection, she started to feel anxious. Withdrawal was setting in. She slumped forward and became sick.
Stephanie ultimately gave in. “I need to leave. I have to go home and take a hit.”
She had used fentanyl before seeking medical help and had only a brief window to get treated before she was compelled to leave to get high again. She thought she still had a month remaining to figure out how to get clean and give birth.
The attending nurse disagreed. She told Stephanie she was not going anywhere.
“I will go,” Stephanie said.
But the hospital refused to discharge her: the leg infection was critical, but physicians found she also had an leakage of amniotic fluid. The nurse, her nurse, warned her: if she departed, she and her baby would face grave danger.
Izzie persuaded the doctor to give Stephanie controlled doses of fentanyl at regular intervals, knowing that symptoms could threaten her and the baby. Once the baby was born Stephanie would be switched to methadone, a treatment that reduces symptoms and is frequently utilized in substance abuse treatment.
After five days, on the 12th of November, Stephanie gave birth to a daughter weighing a small weight – premature, little but surviving.
When the attendant inquired if she wanted to hold her baby, Stephanie said “I cannot.” She was emotionless. Her epidural had failed, her last dose of fentanyl had been provided four hours before delivery.
She felt ill. Ill-equipped for parenting. Not fit.
Stephanie had sought recovery several times during pregnancy, and felt terrible each time she was unsuccessful. She felt without value, berating herself for not being able to achieve the unattainable. An doctor told her to “simply” stop using. Even her source declined to supply to her when she became clearly expecting.
“However, I failed,” she said. “I required assistance.”
The common assumption that her bond with her newborn would make her stop using only led to increased guilt and negative self-talk, a cause for her to relapse. Yet she could not just wish her addiction away, any more than she could eliminate a chronic disease.
The newborn was transferred to the NICU. When Stephanie at last met her, she was attached to medical equipment, so small she thought she would hurt her. Holding her for the first time, she felt nothing. “I gazed upon her and was like, ‘What am I going to do with you?’” She still wasn’t sure she wanted to be her mother.
Two days later she decided to call her daughter the same as her nurse, after the attendant who showed compassion to her.
Hospital staff told her about Maddie’s Place, a innovative treatment home where women and their babies are supported as a unit, not apart.
In many parts of America, where a baby is diagnosed with newborn addiction symptoms every 18 minutes, infants are still quickly moved to hospitals and medicated while their mothers face custody evaluations. But a small, growing network of centers like the care home is showing an important truth: when mothers and babies stay together, outcomes improve, custody cases decrease and overall savings increase.
It took Stephanie a period to find strength to call, but she eventually made the call. After verifying her eligibility for the program, care providers came to bring her to the facility.
She departed the institution still in recovery, fearful and unsure about what would follow.
At Maddie’s Place, Stephanie still worried that CPS would come seize her child – even though she was not sure she wanted to keep her. The concern persisted: that at any point, someone could walk in and separate them.
For the beginning period, Stephanie remained isolated. “I avoided interaction,” she said. “I was suspicious at that point.”
Life on the streets, she said, was about survival. Substances came first; reliance came last.
Stephanie had a single companion, but even that relationship was delicate. The people she loved always found ways to hurt her. She was unable to care for herself, much less anyone else.
Every day, staff from the facility drove her to a treatment center, given as medication. Over time, she was starting to get clean.
She spent every minute when not in sessions with Izzie, and could see that her baby was getting the specialized care she needed. Her daughter struggled with eating at first, with intolerance to some formulas and obvious stomach troubles. She needed feeding therapy. She also had increased sensitivity and required an professional – all common issues for babies affected by withdrawal.
Seeing that even a young person understands the need for care, then I was capable. I could parent.
On a day prior to the holiday, Stephanie sat in the visitation area, where those still using can come for monitored interactions with their babies. Katie Bunch-Smith, a mentor, stopped by with her own family in tow to deliver baked goods. They all crowded near Stephanie, who was sitting on the floor holding Izzie.
The kids looked amazed in wonder of the tiny infant in Stephanie’s arms. “They were innocent,” Stephanie said. “My past did not matter to them. None of those things mattered to them.”
She holds a picture of the moment. She is wearing casual attire, a gray knit hat with a pompom on her head, resting on the floor with the door behind her. She is lean. Her head is tilted forward so you miss her features. She is holding Izzie up on her leg for the other kids to see and they are gathered around, fawning and reaching out to the baby.
Jacob, eight, asked the moms: “Why are there no men?” The parents responded that the fathers had obligations, handling responsibilities, that they would be there if they could.
“In the future,” Jacob said, “I plan to be a great parent. I will teach them about love.”
Stephanie and her companion made eye contact. “I just lost it and fell apart,” Stephanie said. “When a child recognized that infants need affection, then I found the courage. I could be a mom.”
Methods to address infants affected by substances have existed for decades.
The Finnegan NAS scale was developed in 1975|
